Individual provider Active NPI

Shannon Rebecca Segaloff, APRN

  • Pediatrics Physician
  • Boynton Beach, FL
National Provider Identifier
1679041891
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
APRN9278265 Issued in FL
Practice address
6080 Boynton Beach Blvd Ste 240
Boynton Beach, FL 33437-3586
Phone
(561) 509-5009
Fax
(567) 738-0556
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X APRN9278265 FL Primary

Addresses

Primary practice location

6080 Boynton Beach Blvd Ste 240
Boynton Beach, FL 33437-3586

Mailing address

6812 Bridlewood CT
Boca Raton, FL 33433-3591
Phone (954) 732-7858

Other practice location 1

12955 Palms West Dr Ste 100
Loxahatchee, FL 33470-9212
Phone (561) 798-2468

Other practice location 2

5589 Okeechobee Blvd
West Palm Beach, FL 33417-4486
Phone (561) 471-1144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9278265FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sobia Najm Masoud MD.PA. Pediatrics PastSince Jun 6, 2021 Accepting new patients
Palm Beach Pediatrics, LLC Pediatrics Past Accepting new patients
Robert W. Wilson, D.O., P.a. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1679041891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6812 BRIDLEWOOD CT",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333591",
            "telephone_number": "954-732-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 BOYNTON BEACH BLVD STE 240",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373586",
            "telephone_number": "561-509-5009",
            "fax_number": "567-738-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12955 Palms West Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Loxahatchee",
            "state": "FL",
            "postal_code": "334709212",
            "country_code": "US",
            "telephone_number": "561-798-2468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5589 Okeechobee Blvd",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334174486",
            "country_code": "US",
            "telephone_number": "561-471-1144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGALOFF",
        "first_name": "SHANNON",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "APRN9278265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.